Survey - David Cook's Radon Services

Name *

Phone Number *

Email *

What is your age? *

What is your gender? *

What is your ethnicity? *

What city do you live in? *

Have you heard of radon? *

Yes

No

Do you know the health effects of radon? *

Yes

No

If yes, please list below

On a scale from 1-10, how serious of a health concern do you think it is? *

Would you like to find out more about radon? *

Yes

No

Would you be interested in a free test? *

Yes

No

If no, please explain

What would motivate you to get your home tested for radon?

If you know that radon is a concern and you haven't tested your house, what is preventing you?

Are you aware that radon levels are elevated in nearly half the homes in Walworth County? *

Yes

No

Do you currently have a radon mitigation system in your home? *

Yes

No

If yes, is it an interior system or an exterior system?

Interior

Exterior

What year was it installed?

Are you aware that the EPA recommends testing your home every two years if your home has a system? *

Yes

No

How do you feel about a no obligation, free in-home radon evaluation? *

What questions would you have for the person providing you with the evaluation? *

If you know the radon levels are high in your home, what's preventing you from installing a system? *

Do you think if you were better educated about radon, you would have an easier time making a decision? *

Yes

No

Would you be interested in a free educational seminar about radon? *

Yes

No

What questions do you have about radon? *

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262-749-4266

Radon Survey